JESSE ENNIS (PA-C) – Physician Assistant, NPI 1063810844
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,161 PHYSICIAN ASSISTANT in CO
Provider Addresses for JESSE ENNIS (PA-C)
16951 E Quincy Ave
Aurora, CO 800151901
Phone: (303) 752-5480
Fax: (303) 752-5481
Type: Location
4201 BARTLETT ST
HOMER, AK 996037015
Phone:
Type: Mailing
16951 E QUINCY AVE
AURORA, CO 800151901
Phone: (303) 752-5480
Fax: (303) 752-5481
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-09-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211228001970 | I | Physician Assistant | CO | TBD |
| I20231218002401 | I | Physician Assistant | TX | TBD |
| I20240918001331 | I | Physician Assistant | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 19 | 19 | $0 |
Insurance plans in this area (ZIP 80015)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CO | |
| - | KS | |
| Family Practice | KS | |
| Colorectal Surgery (Proctology), General Surgery | CO | |
| - | KS | |
| Physician Assistant | CO | |
| Physician Assistant | CO | |
| Clinical Social Worker | KS | |
| G A S T R O E N T E R O L O G Y | CO | |
| P O D I A T R Y | MO |
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